Brief Answer:
Hi Such bleeding could be due to mutliple causes.I would advice following-

Detailed Answer:
Hello mam,
I did review your concern and also the image of your bruise.

Such bruises along with bleeding gums can be seen with a vessel problem or platelet problem or rarely a coagulation problem.

Vessel problem in your case could be due to vitamin C deficiency, recent medications like steroids, warfarin or herbal medications like gingko or it could be a vasculitis.

Platelet problem can be due to low platelet problem or due to improper platelet function.
Coagulation related problems are relatively uncommon in females but can be seen.

I would recommend following initial tests
1)Complete blood count with morphological view of peripheral smear.
2)Bleeding time,PFA-100, PT and APTT test as part of coagulation profile.
3)ESR and autoimmune screen like ANA XXXXXXX for vasculitis.
4) Also please let me know if you are on any medications.

Meanwhile I would recommend you to have a diet rich in citrus fruits like oranges and lemons and pineapple along with green leafy vegetables to take care of vitamin deficiency component.

I hope this helps
Wish you all the best
Let me know if you have any more questions or concerns.
I will be more than happy to help.
Also please provide me feedback on your health and condition.
Wish you all the best mam
Sincerely,
Dr Parth Desai

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Brief Answer:
I would recommend following for further studies

Detailed Answer:
Hello mam,
thank you for your reply.
SInce the blood tests are normal it rules out any major bleeding disorder due to low platelets or coagulation factors.
If you are still having frequent episodes of bleeding gums along with bruise on arms and legs then it could be because of platelet function defect or due to vascular cause like vitamin C deficiency.

Platelet function tests are not done in routine blood test.
I would recommend you to consult a local hematologist and discuss with him regarding PFA-100, vonwillibrand factor assay and other platelet function studies. These are specialized test done by hematologists and their labs only.

Also if they also come out normal, Its more likely your problem is due to vascular problem and its a huge list of differential diagnosis then but mostly it is due vitami n C deficiency. Also if ESR and autoimmune screen is not done as I previously suggested I would recommend that too for a complete picture.
Also please let me know if you are on any medications or experiencing heavy menstrual bleeding recently.
I hope this helps.
let me know if you have any more questions or concerns.
I will try my best to help you
Also provide me feedback of your health.
Wish you all the best.
Sincerely,
Dr Parth Desai

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